The Emotional and Physical Toll of COVID-19 Burial Teams in Ghana

by Jon Scaccia December 11, 2024

The COVID-19 pandemic left no corner of the globe untouched, creating a wave of fear, loss, and disruption that continues to ripple through societies. Among those on the frontlines were Ghana’s Environmental Health Officers (EHOs), an often-overlooked group tasked with the heart-wrenching and hazardous responsibility of burying the pandemic’s victims. These workers faced unimaginable challenges, from shortages of personal protective equipment (PPE) to psychological trauma. Their experiences shed light on critical gaps in disaster preparedness and the urgent need for reforms in how we protect those who protect us.

The Hidden Cost of COVID-19 Burials

While much attention during the pandemic focused on healthcare workers, the role of EHOs in managing the dead was equally vital—and dangerous. These workers faced constant exposure to physical and psychological hazards. Many contracted the virus themselves due to inadequate PPE supplies, with some sustaining injuries during the burial process. Psychological scars ran deep as EHOs endured verbal abuse, threats, and stares of suspicion from grieving families and the public. One officer recounted being confronted by a cutlass-wielding relative, highlighting the volatile environment in which they worked.

The EHOs’ physical safety wasn’t their only concern. They also grappled with profound emotional burdens. Fear of contracting the virus—and potentially passing it on to their families—was a daily reality. One officer lamented, “I couldn’t sleep for weeks, wondering who would care for my wife and children if I got sick.” Yet, no psychological support was offered to help these workers process their trauma.

PPE Shortages: A Crisis Within a Crisis

A recurring theme in the EHOs’ accounts was the chronic shortage of PPE. Double-gloving and frequent mask changes became their improvised solutions, but these practices only depleted limited resources faster. At one point, burial services had to be temporarily suspended due to lack of protective gear. The absence of sufficient PPE not only exposed workers to higher infection risks but also compromised public health safety, as the risk of virus transmission from improperly managed burials increased.

The PPE crisis wasn’t unique to Ghana. Globally, the pandemic exposed a dangerous dependency on fragile supply chains for critical health equipment. However, for workers in Ghana—already operating within resource-constrained environments—the situation was especially dire.

Psychological Hazards and Stigma

Beyond the physical risks, EHOs endured profound psychological challenges. The stigma associated with their work amplified their isolation. Many were ostracized, verbally abused, and even cursed by community members. Families of the deceased, frustrated by burial restrictions that disrupted traditional mourning rituals, often redirected their grief and anger toward the officers.

The lack of psychological support for these workers was glaring. Despite facing daily exposure to death, uncertainty, and public hostility, they were left to rely on one another and their families for emotional support. The absence of trained clinical psychologists in burial teams marked a significant oversight in Ghana’s pandemic response.

Lessons for the Future: Building a Resilient Workforce

The experiences of Ghana’s EHOs underscore urgent areas for improvement in pandemic preparedness and response:

1. Investing in PPE Supply Chains: Ensuring an adequate and reliable supply of PPE is non-negotiable. Governments must establish stockpiles and explore local production to mitigate future shortages.
2. Psychological Support for Frontline Workers: Clinical psychologists must be included in burial teams. Routine pre- and post-deployment psychological assessments can help workers cope with the mental strain of their roles.
3. Strengthening Public Health Communication: Combating misinformation about infectious diseases and vaccinations is critical. The vaccine hesitancy among some EHOs reflected broader societal fears fueled by misinformation. Proactive education campaigns can build trust and encourage vaccine uptake among both workers and the public.
4. Security for Burial Teams: Providing security personnel to accompany EHOs during volatile situations can reduce the risk of threats and physical harm.
5. Adhering to International Guidelines: A unified global standard for handling infectious disease fatalities, including repatriated bodies, is needed. Clear, enforced protocols can protect workers and reassure the public.

The Broader Implications

The EHOs’ experiences reveal a deeper issue: the global undervaluation of deathcare workers. Their stories highlight the pressing need to reframe how we view and support those performing the critical but grim task of managing fatalities during pandemics. By addressing the gaps in resources, training, and support systems, we not only protect these workers but also honor the dignity of those who have passed.

As the world braces for future public health crises—be it another pandemic or outbreaks of diseases like Ebola or Dengue Fever—the lessons from Ghana’s EHOs must guide our preparations. Investing in the safety and well-being of frontline workers is not just a moral imperative; it is essential to the resilience of our public health systems.

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